07 Jun Dealing with Health Anxiety in Chronic Illness
For those of us living with long term health issues we are familiar with the disconcerting feeling of noticing a new symptom or the rearing of an exacerbation of your condition and the accompanying emotions of apprehension, anxiety or dread; the worry of how to manage it, how to re-arrange your life temporarily to accommodate it and ensuing physical discomfort and doctors appointments. Just writing this I notice the physical sensations of recalling these moments. The common unfortunate side effect of long term illness and recurring exacerbations can be a fairly constant backdrop of anxiety which easily becomes front and centre in our awareness simply from noticing a body sensation, dealing with the medical system or taking medications. As a younger person I used to find it too confrontational and anxiety inducing to connect to others with the same illness as me or even reading about it. And I don’t know about you but gritting my teeth or forcing myself to try not to have anxious feelings wasn’t helpful. These days, and many years and much mindbody education later, I feel more informed, empowered and emotionally regulated to deal with anxious feelings when they come up.
So for those of us who aren’t happy to just live with that constant “hyperarousal” making us feel jumpy, plagued by worry and invasive thoughts, what can we do that is more effective than our mind trying to convince us that we are actually ok even though we don’t feel it?
Step one is understanding a bit about what is actually happening in our body and mind when anxiety shows up. If you take away anything from this short blog, let it be that your anxious feelings are mostly physiological (body) NOT psychological. For many years anxiety, depression and stress were thought to be ‘mental health’ issues and currently your medical team will probably still be classifying it that way. This is outdated thinking; research from the last 30 years or so shows us that anxiety lives mostly in our nervous system, aka the body, not the brain.
Anxiety in the body?..
Your nervous system is the interface between your body, your brain and your environment and includes the brain, spinal cord and all peripheral nerves that spread through the rest of your body including organs, muscles, limbs and skin. Although intelligent beings with the power of rational thought, evaluating and problem solving, we still have our most primal instinct to survive. Our nervous system is still primed to sense anything that serves as a potential threat to our survival and respond accordingly. You have probably heard of our fight or flight response, well we have more nervous system reactions than just that – for example, we can freeze in the face of perceived threat or even disconnect/go numb when our bodymind senses that fight/flight/freeze won’t help us in that moment.
You may be thinking what has all this got to do with my health anxiety? Well anxiety is an increased arousal state (fight/flight/freeze) that our body sends us into when information is received either from internally (a physical symptom or uncomfortable sensation) or external situations or interactions. When we experience a distressing or painful situation as in the case with chronic illness our brain and nervous system store those sensory memories so that we avoid them in the future – unfortunately the repetitive nature of long term illness means that any future similar situation will raise these aroused states of anxiety as our body attempts to remind us to stear clear of such distress and pain for our physical and psychological safety and wellbeing. Our nervous system hasn’t learnt from evolution that chronic illness is something we can’t escape or fight, so it still sends us into an alert state.
What fires together wires together
Our nervous system is adaptive, which can can be useful or detrimental. When an emotion like anxiety is repeated over and over again, our neural (nerve) pathways towards this emotion and physical sensation are amplified, meaning we go easier and quicker into anxious feelings and it becomes more difficult to find and reach that calm, grounded state of feeling safe. On the other hand, it also means that when we learn how to work with our nervous system, we can actually reduce our anxious states due to this “neuroplasticity” or reshaping quality.
Working with our nervous system
The reason why cognitive or behavioural therapy only partially works for health anxiety is because we need to give the message
to our nervous system that we are safe and this happens at a sensory or body level, not a cognitive thinking level. This kind of communication, in the form of sound, imagery, touch, movement and breath, will allow our system to come into a calmer, less alert state where we can feel more at ease in our body and mind and then maybe make cognitive choices, actions or clear communication.
So how do we go about changing our nervous response? With compassion and patience- we can’t force our nervous system into anything, but we can gently guide it towards sensing and feeling safety, capability, connection and support. Our nervous system is the first responder of situations and doesn’t connect to our higher brain of rational thought – so that’s ‘thinking our way out of it’ off the table. Through introducing soothing touch, calming sound, supportive and expressive movement and comforting imagery our primal sensory system will receive direct signals of safety and reduce the arousal level, leaving us feeling more in control and able to think clearly and feel more emotionally regulated.